ENCEPHALOS 56, 16-29, 2019

Abstract

Our article investigates the ways in which the term“dementia”, as well as dementia as a disease,appears and is described in ancient texts. In otherwords, we record the context ascribed to dementiaand to the relevant to dementia diseases in varioustexts. Firstly, we locate the relevant citations in twoEgyptian papyrus scrolls and then we look into thecontext ascribed to the term “dementia” in the texts ofGreek writers up until the 7th century A.D.Namely: 1. In Ebers’ papyrus scroll we encounter ageneral description of the dementia disease, thatresembles the description of the disease we usetoday, without, however, the actual use of the term“dementia”. 2. In Edwin’s papyrus scroll there is acitation of a disease that resembles that of aphasia.3. The term dementia as a state of thoughtlessness,carelessness and foolishness, can be found in thetexts of many writers/poets, .4. Hippocrates was thefirst that used psychiatric terms. 5. Galen, the secondmost important doctor of Greco-Roman times, afterHippocrates, was the first to name dementia as a dis-ease and the first to describe it. Apart from dementia,he, also, names and describes around thirty more“diseases of the mind”. 6. Paul of Aegina, five cen-turies later, he lived in the 7th century A.D., recog-nizes the importance of Hippocrates’ and Galen’swork.

Keywords: ancient medicine, dementia, Galen,mental diseases

Introduction

Our article is divided in two sections. In the first sec-tion we describe the context ascribed to dementiaand to the relevant to dementia diseases in varioustexts, starting from two Egyptian papyrus scrolls andsubsequently, we look into the ascribed context ofdementia in the texts of Greek writers. Our researchhad the following findings:A) Ebers’ Egyptian papyrus scroll (which is estimatedto have been written around 1555 B.C.) is, accordingto our research, the most ancient text to include thelargest number of citations of diseases relevant todementia. For example, amongst other things, thereis a mention of the fact that “at an old age, there is adeterioration of the mind and our ability to rememberthings”. In this papyrus scroll there is no actual men-tion of the term “dementia” but we do find a generaldescription of the disease of dementia, which match-es our understanding of dementia today. B) Edwin’s papyrus scroll was written in 1700 B.C.but is based on a text that dates back approximatelyto 3000 B.C. Here, we have a mention of a diseasethat is very similar to aphasia (Edwin’s papyrusscroll, Case 22).C) The term dementia as a state of thoughtlessness,carelessness and foolishness, can be found in thetexts of many writers/poets, such as: Homer,Anaxagoras, Democritus, Plato, Aristotle, Aretaeusof Cappadocia et al., while Hippocrates used manyother psychiatric terms of other scientific fields, suchas Mania, Melancholy, Phrenitis, Insanity andParanoia, that we are presently, also, using. Subsequently, in the second section, our researchfocuses on Galen’s body of work (129 A.D. – 199A.D.), the second most important doctor of ancienttimes, after Hippocrates, and the last distinguisheddoctor of Greco-Roman times. It is in Galen’s bodyof work that we first come across dementia to becharacterized as a disease. Therefore, the aim of ourresearch is to locate dementia and the relevant todementia diseases within his body of work. Galen,apart from dementia, also described another twenty

How are Dementia and the Relevant to Dementia Diseases Recorded inTexts Dating Back to 1555 B.C. and up until the 7th century A.D.: TheCase of Galen and of Paul of Aegina

ANARGYROS B. KARAPETSAS*, PANAGIOTIS B. MANDRAKIS**

*Professor of Neuropsychology and Neurolinguistics at theUniversity of Thessaly, Department of Special Education

**PhD Student in the University of Thessaly, Department ofSpecial Education, pmandr@ymail.com

mailto:pmandr@ymail.com

17

five “diseases of the mind”, such as: ecstasy, amen-tia, skotomatikon (vertigo), phrenitis… We have cat-egorized those in alphabetical order. We have mainlylooked for treatment methods of the above men-tioned diseases in Galen’s and Paul’s of Aeginatexts. Given that there is an interval of approximatelyfive centuries between the works produced by thesetwo writers, we compare their suggested treatmentmethods in order to determine how similar they are.Through our research we have, also, found that: 1. arecorded description of mental illnesses relating todementia can be found back in the 17th century B.C.2. In a text written in the Greek language byHippocrates one can find psychiatric terms relevantto dementia, while dementia as a disease is firstencountered in Galen’s body of work. 3. In Galen’sbody of work, apart from dementia, we, also, findseveral similar mental illnesses. 4. The treatmentmethods suggested by Paul of Aegina remain thesame after five centuries and match those proposedby Galen and Alexander of Tralles. According to Paulof Aegina, there are doctors that worked in the pastand those that are more recent. The last from thosethat worked in the past is Galen, who he considers tobe a milestone in medicine. We offer a translation ofPaul’ s of Aegina preface in his seven-volume book1:“This body of work (Medical epitomes in seven vol-umes) was written by me not because somethingthat the doctors that came before me wrote in theirworks or practiced (in their medical profession) isconsidered to be outdated. This is more of a synopticmanual, because while those doctors worked withgreat diligence, correctly and extensively, for theirprofession (medicine), more recent doctors, withouteven feeling the need to read this body of work, havethe audacity to accuse them of verbosity”. He consid-ers Hippocrates’ and Galen’s body of work to be cor-rect2. Of the more recent doctors (that came afterGalen), he mentions Oribasius (he lived in the 4thcentury A.D.). He, as Paul of Aegina mentions, didproduced a notable body of work, but the epitome ofthe work he produced, which he dedicated to his son,Eustathius, had many shortcomings3 …..”and that iswhy I have prepared this epitome of the body of workof the ancients. I had refrained from including myown views, apart from a few on matters that I havenoted and have tested in practice”. Krug argues that Galen constitutes both a peak anda borderline for medicine of ancient times, meaningthat Galen had pushed the medical science to reachthe limits of its potential. The vast body of work thathe has produced created the impression that it is

impossible for someone to add something more to it,let alone surpass it (Krug, 2008 p. 210). BothAlexander of Tralles and Paul of Aegina, for example,not only offer the same definition of lethargy but they,also, use very similar wording.

FIRST SECTION

The various types of dementia4 constitute an impor-tant field of neurodegenerative diseases connected,mainly, with old age. It is estimated that in the year2025, approximately 1.2 billion people above the ageof 60 will suffer from some type of dementia. It is ofgreat interest, therefore, to see what people knewabout dementia and what type of treatments theyproposed through time. In this context, we havefound that it was Galen that first studied dementia.However, by studying Galen’s views on dementia5 -given that he had lived in the 2nd century A.D.- wedo not wish to go back in time, but rather to moveforward, using Galen’s views. The anticipated risein Alzheimer type of dementia cases in Greece in thecoming years constitutes a major problem that has tobe dealt with. It is a significantly aggravating diseasethat requires a coordinated effort from the part ofsociety, science and the state in order for supportand help to be provided to the patients and their fam-ilies. Through our research we have, also, found that theoldest text that contains references to the symptomsof dementia is Ebers’ papyrus scroll, which was writ-ten at around 1555 B.C. (Finger, 1994, 2000). Thispapyrus scroll contains the description of approxi-mately 900 medical prescriptions for the treatment ofspecific disorders. Amongst other things, we have,also, found that it was observed that in some of thepatients: 1. there was ‘‘perishing of the mind and for-getfulness’’6. 2. That “(the patient’s) mind isdrowned; this means that his/her mind is forgetful likeone who is thinking of something else.”7 3. It was,also, observed in a patient: “the mind’s kneeling: thismeans that his/her mind is constricted”8. “The mindkneels through purulency: this means that his/hermind is small in the interior of his/her belly”9. 4. As faras the “drying up of the mind” is concerned: “it is (dueto the fact) that the blood coagulates in the heart”10.5. In another patient, however, “his/her mind is con-tracted, there being darkness in his/her, interior”11. In Edwin’s papyrus scroll12 some of the symp-toms of aphasia are: in Robert H. Wilkins’ translit-eration from hieroglyph to English13 we read the fol-lowing: “One having a smash in his/her temple;

ENCEPHALOS 56, 16-29, 2019

18

he/she discharges blood from his/her two nos-trils and from his/her ear; he/she is speechless;(and) he/she suffers with stiffness in his/herneck. An ailment not to be treated.”14 It should benoted that the papyrus scroll in question is divided inCases15. Each one of the cases contains six parts:A. the Title: (which includes a summary of thepatient’s case and what it is about). B. The main part,titled Examination and Diagnosis (here we find amore detailed report on the observations concerningthe patient’s condition). C. What kind of treatment (ifany) is proposed for the particular case16. Thepapyrus scroll contains in total 48 cases. The samecase, case 2217, that can be found in theNeuroscience for Kids; The Edwin Smith SurgicalPapyrus18, is considered to be the first case that cor-roborates aphasia19. His comment about case 22 isthe following: “Fracture of the temporal bone (ofthe skull). This patient could not speak and thiscase is thought to be the first to document aphasia.If this is a description of aphasia, it would pre-date the famous work on aphasia by Paul Broca(1861) by thousands of years! Case 22 was “Anailment not to be treated.”The descriptions of these disorders state that theEgyptians used the same methods in order to dealwith both mental and physical illnesses. The papyrusscroll (The Edwin Smith Papyrus) was published andtranslated by various researchers (the German edi-tion, Grundriss der Medizin der alten gypter, is con-sidered to be the best and is based on PaulGhalioungui’s publication)20.Moving on to Greece, we need to first examineHomer, one of the oldest and greatest poets. InHomer, as in other poets, the term senseless meansfoolish21, he who has no sense, no brain, and theadjective “νηπύτιος” is often used (which derivesfrom the word νήπιος, which means silly, stupid). Inrhapsody F of Iliad, in the very meeting between theGods with the purpose of deciding whether theyshould take part in the war, aiding the two sides atwar (Trojans-Greeks) or if they should depart, it is thegoddess Athena who first calls Ares, the god of war,stupid, νυπήτιο22, for trying to compare himself toher, as far as valor is concerned, and 30 versesdown, Poseidon, also, uses the same characteriza-tion (νηπύτιο) for the god Apollo, who is younger thanhim, claiming that Apollo possesses a foolishheart23· In Homer, we, also, come across the term‘senseless’ (ανοήμων) that means imprudent24. Theterm νόος (perception, sense), finally, is used formore than a 100 times in the text. Dementia as lack

of mind, can, also, be found in the texts of other writ-ers and poets, such as: in Aeschylus, Theognis,Anaxagoras 25, Democritus 26, Plato etc. Plato high-lights that dementia has a different context to good-will (ευήθεια)· goodwill or gullibility has a positivecontext · ευήθεια = well constructed, (in term of)ethos, mind· therefore, dementia is a poorly con-structed, (in terms of) ethos, mind27 .Hippocrates used psychiatric terms that we still usetoday, such as: Mania, Melancholy, Phrenitis,Insanity and Paranoia. He was, also, aware of preg-nancy psychosis and alcohol-related psychosis.Finally, we should, also, add that Hippocrates hadnovel concepts about the beneficial impact of fever(fever therapy) and sleep (sleep therapy) on neu-ropsychiatric diseases. He, also, talked about psy-chotherapeutic and psychiatric examination. Thiscan be found in his book titled About humors (Ε 488-9), in which he tries to gather information with regardto the patient’s personality (possible abuses, sleeppatterns, physical and mental fatigue etc.). Many ofHippocrates’ psychiatric perceptions serve as amodel of scientific way of thinking even today. Aretaeus of Cappadocia, who lived during the firstyears of postchristianity, describes, also, variousmental diseases, that he divides in three differenttypes: mania, melancholy and insanity. Finally,Epiphanius, an ecclesiastical writer that lived duringthe 4th century B.C. and fought against heretics,couples the heretics’ dementia with their lunacy28.We have, also, found that Paul of Aegina was familiarwith Alexander of Tralles’ work, since he describesdiseases, such as lethargy, in the same way as hedoes.

SECOND SECTION

GALEN29Galen was born in Pergamum. At the beginning, hestudied medicine in Pergamum and later on inSmyrna, Corinth and Alexandria. In order for him tocomplete his studies, he became a surgeon toPergamum’s gladiators (fighters-slaves) for fouryears. Galen studied the brain through experimenta-tion (Karapetsas, 2011 p.22). He establishedPhysiology and Anatomy30. After Hippocrates,Galen was the next Greek doctor to deal extensivelywith brain diseases and their surgical treatment. Heperformed numerous dissections and offered valu-able knowledge and observations that helpedcement medical thinking and practice for almost fif-teen centuries31.

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19ENCEPHALOS 56, 16-29, 2019

Despite the influence Galen’s body of work hasexerted on medicine of the middle and more recentyears, never the less, the study of his body of work isnot as extensive today as Hippocrates’ body of work.The more, however, Galen’s work is studied, themore its depth, its importance and its focus on med-ical research32.

The names that Galen gave to mental health dis-easesIn Galen’s surviving texts, as well as those character-ized by some of the scientists as being the texts ofPseudo-Galen, we looked for diseases of the mindand the ones we were able to locate are presentedbelow in alphabetical order. Through our research wehave come across (27) twenty-seven diseases andthey read as follows:1. Amnesia (21 citations33): The cause of amnesia(lithi)34, as in similar mental illnesses, is the abnor-mal fluids (humor) created in the body. 2. Anaesthesia (62 citations): When the overflowbrain fluid (humour) is cold, humans experience lackof sensation (anaesthesia) and immobility 35.3. Apoplexy (95 citations): Apoplexy (paralysis) is amental “possession” that is followed by anaesthesia.The patient looses all consciousness and the abilityto move (paralysis). The cause is the inflow of coldfluid (humour) that fills the ventricles of the brain36 .During apoplexy, the whole of the body is paralyzed37. Democritus compares intercourse to a mild typeof apoplexy 38. 4. Carus39,40 (70 citations): Carus (unconscious-ness) is a form of lunacy characterized by lassitude.When the patient suffers from carus, his fantasy andhis logic are impaired. One of them might work, whilethe other does not. It is connected with the presenceof cold fluids (humor) in the brain41. Paul of Aeginasaid that: carus resembles lethargy, while the loss ofmemory and reason is due to cooling425. Catalepsy: (109 citations). : Form of lunacy43.Fantasy and logic are impaired6. Cataphora (77 citations)44 : cataphora (deepsleep) is deep and “difficult to reverse”. The patientsare exhausted and forgetful of everything they say.7. Coma: (128 citations): Coma45 occurs due toextreme coldness in the brain or weakness of thebody, as was the case with Hermocrates. Galendivides coma into: 1. Deep coma (eyes shut) and2. Awake non responsive coma (eyes open). Hecalls the awake non responsive coma deep or vege-tative coma. The same term (awake non responsive coma) is

used by Paul of Aegina, to which he proposes phle-botomy as a treatment. He highlights that the dis-eases could become very dangerous“εἴ που διά τινα τροφῆϲ ἢ πόματοϲἁμαρτάδα (ἁμαρτάδα=sin=inexpediency,error) γένηται” if the patient eats or drinks somethingthat it is prohibited…

8. Delirium (24 citations): It is phrenitis coupled byhigh fever. The patient pulls out the lint from woolenfabrics, is in an ecstatic trance, is forgetful, getsscared and cannot speak properly46. It is divided inlethargic or frantic delirium.9. Dementia (13 citations): According to Galen,dementia (failure of mental function) is connected toabnormal brain fluids (humours). The fluids can be:1. Cold. The patient experiences lack of sensation(anaesthesia), immobility and inertia when the over-flow brain fluid (humour) is cold. 2. Warm. When theoverflow brain fluid (humour) is warm, the body is“agile” and thought is impaired47. (12). 3. The abnor-mal flow of fluids (humours) in the body affects thesoul and behavior. The fact that the soul’s memory ispossible to exhibit such symptoms, both when some-one is ill and after his recovery, is something that,also, Thucydides has pointed out, when he statedthat some of the people that were rescued from theplague repressed any memory of what came beforeto such a degree that they ended up forgetting whothey really were48. Dementia, also, exists in cases ofmelancholy but in those cases is reversible, sincewhen the melancholy stops, mental function isrestored49.10. Ecstasy (26 citations): According to Galen,severe cases of lunacy50 are called ecstasy. In othertexts by Galen, he, also, informs us that ecstasy is aform of short term mania51. 11. Epilepsy (102 citations): When the thick melan-cholic fluid (humor) flows into the ventricles of thebrain, many times it leads to epilepsy52.12. Forgetfulness (epilismosyni) (6 citations): Thiscan be caused by the use of drugs or by certainabnormal fluids (humour) created in the humanbody53. 13. Heterocrania (9 citations): A headache that alter-nates from the left to the right temple (of the head)and its intensity increases5414. Katochi: (27 citations): Katochi was a group ofdiseases of the brain55. Their characteristic is con-vulsions.

15. Kefalaia: (22 citations): A disease characterized

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by headaches that sometimes are unbearable, andthe patient hears noises and his eyes are bulging56

16. Lethargy: (70 citations). Lethargy is called thecataphora (deep sleep) that is hard to be reversed,the patient is pale, and there is oedema with gas,coupled with lassitude57 . When there is some typeof degeneration/sepsis and is coupled by fever, thisdisease is called lethargy58. Both Alexander of Tralles and Paul of Aegina, notonly offer the same definition of lethargy, but they,also, use the same wording59 in order to describethe disease. In the text that is about nine lines long,where the two writers refer to lethargy, one canobserve the following similarities between the twotexts.1. The space within the human body that is connect-ed to lethargy is the brain and is the same as phreni-tis 2. The “matter” of lethargy and phrenitis is opposite 3. In lethargy there is liquid and cold phlegm damp-ening the brain4. Those that suffer (from lethargy) are forgetful andstupefied From the above mentioned examples we conclude

that it is very likely, as confessed by Paul of Aeginain the preface of his work, that the common express-es between the two writers are the same words thatGalen used in his lost works, which the writers bor-rowed. Treatment of lethargy: According to Galen, a hotbeverage with thyme, pennyroyal vinegar andoregano and other similar herbs should be preparedand should be placed near the patient’s nose, so thatthe steam of the beverage will reach the patient’sbrain, in order to destroy the thickness of the fluid(humor). 13. (GALENUS Med. De methodo medendilibri xiv {0057.066} Volume 10 page 930 line 4). The treatment suggestions for lethargy proposed byAlexander of Tralles (from Caria, 6th century A.C.)and by Paul of Aegina are the same as those pro-posed by Galen.17. Madness (337 citations): Madness is connectedto the prevalence of yellow bile in the brain. In thecase of madness60, both fantasy and logic areimpaired. Sometimes only one of them functionsproperly, as was in the case with Theophilus61, thedoctor that suffered from this disease. He had theability to have a reasonable conversation and wasable to recognize the people that were present.However, he believed that a group of people playing

the flute had taken residence at a corner in hishouse, some of them standing and others sittingdown, and played the flute day and night, makingnoise. (He felt that the flautists) played constantlythroughout the day and the night, even for a fewhours, and he would yield at them to get out of hishouse. That was the type of his madness. When herecovered from his illness and his visitors recountedto him all that had taken place, he was able toremember the ghosts of the flautists. For somepatients, however, no ghost appeared beforethem62.18. Mania63. (54 citations): Mania is the ecstasy ofthe mind and the change in a person’s habits. It is notcoupled with fever64.

19. Melancholia: (78 citations). Melancholia is anaffection that harms the thought process; it is cou-pled with dysthymia and an aversion towards previ-ously beloved activities. It occurs when blood iswedged in the brain. For the treatment of this partic-ular disease, Alexander of Tralles (lived in the 6thcentury) proposes phlebotomy of the vein on theforehead65. In the case of melancholia, there is nofever. For the treatment of melancholia Paul ofAegina proposes: 1. we begin with phlebotomy 2.we administer many fluids, 3. Aloe, pistacia, blackhellebore 4. We aim to induce diuresis and sweating,5. Poultices with a mixture of rue, dill, absinthe, pen-nyroyal and silver hairgrass, boiled in oil. He, also,advises that the patient avoids the consumption ofbeef, deer, lentil, cabbages, snails in wine, thickblack wines and in general, whatever creates theblack bile. 20. Morosis/Dementia66 (14 citations): When logicand memory are lost, the disease is called morosis.It can be lost either memory or logic or both together.When both (logic and memory) are lost, logic is lostfirst

21. Narke/Νumbness (59 citations): When a partic-ular nerve is compressed due to cooling or isobstructed due to thick and sticky fluids (humor) orthe patient is suffering due to an external cause, thennarke (numbness) and paralysis are induced andthere are muscle spasms67.22. Paresis: (12 citations). Alexander of Trallesdefines paresis as follows: the disease of paresis(impaired movement) is usually called paralysis. It ischaracterized by unconsciousness and immobility ofthe body that leads to death. That is what separatesthis disease from apoplexy (paralysis)68. Galen

proposes the use of the term paresis for other dis-eases, also, that, probably, are not mental diseasesi.e. “πάρεσιν κύστεως orπάρεσιν ἁπάντων τῶν μορίων τοῦ σώματοϲ” (=blad-der paresis or paresis of a part of the body).23. Paroxysmos: (765 citations). Paroxysms arecoupled with amnesia (lithi), “release” and speech-lessness69. In the above mentioned number of cita-tions (765) that we have considered, the definition ofthe term paroxysmos as the outbreak of any diseaseis, also, included. 24. Phrenitis, (203 citations): It is a mental diseasecoupled with fever70 that affects the hegemonikon(the ruling or controlling principle of the soul). The essentially serious symptoms of phrenitis isinsomnia and the patient seeing ghosts, the manifes-tation of a racing pulse, hyperventilation, dryness ofthe eyes and mainly delirium, which continues tooccur even during very high fever. According toGalen, the logical function of patients that suffer fromphrenitis is impaired, since the mental functioning oftheir souls is impaired. That is what had happened tothe patient suffering from phrenitis, who, on the onehand, locked himself in the room, but, on the other,went to the window, holding each one of his utensils,and asked the passersby if they wanted to see himthrowing them out the window. The patient wasaware of the name of each utensil and that provesthat neither his fantasy nor his memory wasimpaired. Why he felt like throwing out the windowhis utensils? He was unable to understand the rea-sons behind his behavior and he was unable to cor-rect his behavior and that proves without a doubt thathe was unable to think reasonably71.According to Alexander of Tralles (lived in the 6thcentury), the yellow bile is the cause of phrenitis,which turns into madness72.25. Scelotyrbe (=limping): scelotyrbe is a type ofparalysis. (1 citation). In this case the patient isunable to walk straight7326. Skotomatikon74 = causing vertigo, loss of con-sciousness. (19 citations): Some of the patientsexperience vertigo and sometimes they fall down,especially when they spin around themselves. Whilethose who do not suffer from this disease have tospin many times, before experiencing vertigo, forthose that suffer from it, one spin around themselvesis enough to make them experience loss of con-sciousness. For patients that suffer from this dis-ease, vertigo occurs even if they are watching some-one else spinning or if they see a wheel or something

similar spinning or even if they observe water turbu-lence. They, also, experience vertigo when the sunwarms their heads or if a source of heat is near theirheads. Healthy individuals experience the same feel-ing only when they are constantly spinning around75.The same observation is, also, made by Paul ofAegina, who mentions that patients feel dizzy withany kind of spinning that occurs. 27. Typhomania (3 citations): Typhomania is animperfect lethargy. It is a mixed affection thatincludes both phrenitis and lethargy76.

Treatment methods suggested by GalenTreatment of dementia: In the case of dementia,which is coupled with hyperstimulation, at the initialstages of the disease, when its intensity is powerfuland the patient is able to suffer the pain, phlebotomyshould be performed, provided that none of the fol-lowing is prohibiting its execution, such as the num-ber of raw fluids (humor), childhood, the season ofthe year or lastly the temperature of the location (toowarm or too cold). Στην αρχή οξυρόδινον (έλαιον)προσφέρειν = it is common to administer, at the initialstages of the disease, rose hip oil mixed with vinegar,hellebore, mandragora, opium poppy, opium77 andhenbane, and to have diathermy, sunlight therapy,phlebotomy, hydrotherapy, physiotherapy and psy-chotherapy. Galen used henbane, opium and mandragora, buthe, also, mixed substances. The parts of the man-dragora plant (leaves, nut, root extract) have narcoticand analgesic properties, which makes it the numberone choice for the performance of surgical proce-dures. Later on, for the preparation of anesthesia,they used a mixture of mandragora, opium, henbane,conium (hemlock) and lettuce. During the Romantime, the opium that was produced in large quantitiesin Thebes and was exported was renowned. Treatment methods suggested by Paul of AeginaPaul of Aegina belongs to the period of late antiquity;he was a doctor and a writer of the 7th century A.D.He, most likely, was from Aegina. During the time ofthe siege of Alexandria by the Arabs, in 643, Paulmust have been a famous doctor in Alexandria. Atthe great libraries of Alexandria, of Pergamum andKos Island, he had at his disposal the original texts ofbasic medical science. He was particularly familiarwith Galen’s and Hippocrates’ body of work. Paul col-lected and presented in a practical form, all the nec-essary and valuable information that a doctor neededin his everyday medical practice (Krug, p.213). Arab

21ENCEPHALOS 56, 16-29, 2019

http://stephanus.tlg.uci.edu./Iris/indiv/csearch_red.jsp#doc=tlg&aid=0057&wid=043&q=De%20symptomatum%20differentiis%20liber&dt=list&st=work_title&per=50

doctors had taken an interest in the practical, usefuland tested collective works of Oreibasius and Paul ofAegina. Like many doctors of late antiquity, he wasnot himself a researcher, but instead he offered aseven-volume synopsis of the work of the doctorsthat came before him, titled Treatise. In this body ofwork he made sure that he included the essentialmedical material. Therefore, his work contains, main-ly, practical guidelines and at the same time a greatnumber of references to medical tools (Krug, p. 219) In sum: In general, we can find a record of mentaldiseases dating back to the 17th century B.C. In atext by Hippocrates written in the Greek languagethere are psychiatric terms relevant to dementia, butdementia as a disease first appears in Galen’s work.In Galen’s work, along with the term dementia, wecan find several similar mental diseases.

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Neurosurgical Classic-XVII. Edwin Smith Surgical Papyrus.Robert H. Wilkins, MD. Division of Neurosurgery, Duke UniversityMedical Center, Durham, North Carolina. Available at:https://ceb.nlm.nih.gov/proj/ttp/books.htm

Ochs, S. The early history of nerve regeneration befinning withCruikshank’s observation in 1776. Med History 1977, 21:261

Panourgias I.G.( 2001). The History of Neuro-Surgery. PhDThesis. Athens: Study in the History of Medicine. National andKapodistrian University of Athens.

Rigatos, G.(2001). Diseases and doctors in Ancient GreekBooks. Athens: Vita Medical Publications.

Synopsis of the history of research of the human brain.Milestones of neuro-surgery. Available at: http://faculty.washing-ton.edu/chudler/hist.html

Syrmos, N. Historical Background of the most important mile-stones in neuro-surgery. Master Thesis. Thessaloniki: A.U.T.TEFAA, 2007, available at: http://ikee.lib.auth.gr/record/71604/files/gri-2007-308.pdf

Thesaurus Linguae Graecae Digital Library.Ed. Maria C.Pantelia.University of California, Irvine. http://www.tlg.uci.edu(accessed Feb. 10, 2015)

Wolam, D.H.M. “Concept of the brain and his function in classicalantiquity”, στο The history and Philosophy of Knowledge of thebrain and its Functions, Poynter, F.N.L. (ed.), Blackwell, Oxford1958.

ENCEPHALOS 56, 16-29, 2019 23

http://ikee.lib.auth.gr/record/71604/files/gri-2007-308.pdfhttp://faculty.washington.edu/chudler/hist.htmlhttp://faculty.washington.edu/chudler/hist.htmlhttps://ceb.nlm.nih.gov/proj/ttp/books.htmhttp://www.biblionet.gr/author/10566/Antje_Krugfile:///C:/USER/Dropbox/�������%20Edwit%20Smith%20-%20���������/oip4.pdffile:///C:/USER/Dropbox/�������%20Edwit%20Smith%20-%20���������/oip4.pdfhttp://www.pbs.org/wnet/brain/history/http://historymed.blogspot.gr/https://digital.lib.auth.gr/record/80165/files/01.pdfhttp://www.mednet.gr/archives/current-gr.html

Notes

1 1. PAULUS Med. Epitomae medicae libri septem,Book prchapter 1 section 1 line 1-5

2 Galen’s personality as a doctor and a researcheris what created the term ‘Galenism’ in the medicalprofession, a term that survives even today, giventhat his methods had no successors and he was notsucceeded by any school of thought (Krug 1997,pp. 69-71 and 209)

3 PAULUS Med. Epitomae medicae libri septem ,Book prchapter 1 section 1

4We have descriptions of more than 100 types ofdementia. The most common ones are: Alzheimer’stype of dementia, vascular dementia, dementia ofalcoholics, dementia with Lewy bodies, corticobasaldegeneration, and dementia caused by other gener-al medical conditions and the non-determineddementia.

5 Today we know that a primary and early symptomof the disease is the memory disorder. There is diffi-culty in retaining recent information and facts, diffi-culty in finding the right words, reduced fluency.(Karapetsas, Modern subjects of Neuro-linguistics,Speech Pathology, Assessment, Diagnosis andRehabilitation. Page 122).

6 As far as the “perish of the mind and forgetful-ness” is concerned: it is breath of the activity of thereciting priest that does it; it (i.e. the breath) entersinto the lung several times, and the mind becomesconfused through it. The original text: As to “perishing of the mind andforgetfulness”: it is breath of the activity of the recit-ing priest that does it; it (i.e. the breath) enters intothe lung several times, and the mind becomes con-fused through it.

7 “his mind is drowned”: this means that his mind isforgetful like one who is thinking of something else.

8 The original text: As to “the mind’s kneeling(breakdown?)”: this means that his mind is con-stricted, and his heart in its place in the blood of thelung. Becomes small through it. It is (due to thefact) that the heart is hot, and then his mindbecomes weary through it; he eats little and is fas-

tidious.

9.The original text: As to “the mind kneels throughpurulency; “: this means that his mind is small in theinterior of his belly, the purulency falling on hisheart, and so he becomes (;) and kneels.

10 The original text: As to “drying up of the mind”:it is (due to the fact) that the blood (coagulates?) inthe heart.

11 The original text: As to “his mind is dark(melancholic?), and he tastes his heart”: this meansthat his mind is contracted, there being darkness inhis, interior (lit. belly) through (;), and he makes thedeed to consume his mind (i.e. he repents).

12https://ceb.nlm.nih.gov/proj/ttp/flash/smith/smith.html The papyrus is unfolding https://www.google.gr/search?q=the+edwin+smith+papyrus+all+the+text&safe=strict&tbm=isch&source=iu&pf=m&ictx=1&fir=RZ2uOHcnCuiXaM%253A%252COAJeyLDF5eQy6M%252C_&usg=__D2nVFpWEuG1cmj-_gkW6uk1cX70%3D&sa=X&ved=0ahUKEwjN7IjQ-pDXAhWRZFAKHUw6BwgQ9QEIWjAG#imgrc=rVjLP0fadkJW_M: contains many pictures of thepapyrus.

13 Neurosurgical Classic-XVII. Edwin SmithSurgical Papyrus. Robert H. Wilkins, MD. Divisionof Neurosurgery, Duke University Medical Center,Durham, North Carolina athttps://ceb.nlm.nih.gov/proj/ttp/books.htm

14 The original text as it was given to us byRobert H. Wilkins is as follows: Case: Twenty-Two .Title: Instructions concerning asmash in his temple.

Examination: If thou examinest a man having asmash in his temple, thou shouldst place thy thumbupon his chin (and) thy finger upon the end of hisramus, so that the blood will flow front his two nos-trils (and) from the interior of his earhaving thatsmash. Cleanse (it) for him with a swab of linenuntil thou seest its fragments (of bone) in the interi-or of his ear. If thoucallest to him (and) he isspeechless (and) cannot speak... Diagnosis: Thoushouldst say concerning him: “One having a smashin his temple; he discharges blood from his two nos-trils and from his ear; he is speechless; (and) he

24 ENCEPHALOS 56, 16-29, 2019

https://ceb.nlm.nih.gov/proj/ttp/books.htmhttps://www.google.gr/search?q=the+edwin+smith+papyrus+all+the+text&safe=strict&tbm=isch&source=iu&pf=m&ictx=1&fir=RZ2uOHcnCuiXaM%253A%252COAJeyLDF5eQy6M%252C_&usg=__D2nVFpWEuG1cmj-_gkW6uk1cX70%3D&sa=X&ved=0ahUKEwjN7IjQ-pDXAhWRZFAKHUw6BwgQ9QEIWjAG#imgrc=rVjLP0fadkJW_Mhttps://www.google.gr/search?q=the+edwin+smith+papyrus+all+the+text&safe=strict&tbm=isch&source=iu&pf=m&ictx=1&fir=RZ2uOHcnCuiXaM%253A%252COAJeyLDF5eQy6M%252C_&usg=__D2nVFpWEuG1cmj-_gkW6uk1cX70%3D&sa=X&ved=0ahUKEwjN7IjQ-pDXAhWRZFAKHUw6BwgQ9QEIWjAG#imgrc=rVjLP0fadkJW_Mhttps://www.google.gr/search?q=the+edwin+smith+papyrus+all+the+text&safe=strict&tbm=isch&source=iu&pf=m&ictx=1&fir=RZ2uOHcnCuiXaM%253A%252COAJeyLDF5eQy6M%252C_&usg=__D2nVFpWEuG1cmj-_gkW6uk1cX70%3D&sa=X&ved=0ahUKEwjN7IjQ-pDXAhWRZFAKHUw6BwgQ9QEIWjAG#imgrc=rVjLP0fadkJW_Mhttps://www.google.gr/search?q=the+edwin+smith+papyrus+all+the+text&safe=strict&tbm=isch&source=iu&pf=m&ictx=1&fir=RZ2uOHcnCuiXaM%253A%252COAJeyLDF5eQy6M%252C_&usg=__D2nVFpWEuG1cmj-_gkW6uk1cX70%3D&sa=X&ved=0ahUKEwjN7IjQ-pDXAhWRZFAKHUw6BwgQ9QEIWjAG#imgrc=rVjLP0fadkJW_Mhttps://www.google.gr/search?q=the+edwin+smith+papyrus+all+the+text&safe=strict&tbm=isch&source=iu&pf=m&ictx=1&fir=RZ2uOHcnCuiXaM%253A%252COAJeyLDF5eQy6M%252C_&usg=__D2nVFpWEuG1cmj-_gkW6uk1cX70%3D&sa=X&ved=0ahUKEwjN7IjQ-pDXAhWRZFAKHUw6BwgQ9QEIWjAG#imgrc=rVjLP0fadkJW_Mhttps://www.google.gr/search?q=the+edwin+smith+papyrus+all+the+text&safe=strict&tbm=isch&source=iu&pf=m&ictx=1&fir=RZ2uOHcnCuiXaM%253A%252COAJeyLDF5eQy6M%252C_&usg=__D2nVFpWEuG1cmj-_gkW6uk1cX70%3D&sa=X&ved=0ahUKEwjN7IjQ-pDXAhWRZFAKHUw6BwgQ9QEIWjAG#imgrc=rVjLP0fadkJW_Mhttps://www.google.gr/search?q=the+edwin+smith+papyrus+all+the+text&safe=strict&tbm=isch&source=iu&pf=m&ictx=1&fir=RZ2uOHcnCuiXaM%253A%252COAJeyLDF5eQy6M%252C_&usg=__D2nVFpWEuG1cmj-_gkW6uk1cX70%3D&sa=X&ved=0ahUKEwjN7IjQ-pDXAhWRZFAKHUw6BwgQ9QEIWjAG#imgrc=rVjLP0fadkJW_Mhttps://www.google.gr/search?q=the+edwin+smith+papyrus+all+the+text&safe=strict&tbm=isch&source=iu&pf=m&ictx=1&fir=RZ2uOHcnCuiXaM%253A%252COAJeyLDF5eQy6M%252C_&usg=__D2nVFpWEuG1cmj-_gkW6uk1cX70%3D&sa=X&ved=0ahUKEwjN7IjQ-pDXAhWRZFAKHUw6BwgQ9QEIWjAG#imgrc=rVjLP0fadkJW_Mhttps://ceb.nlm.nih.gov/proj/ttp/flash/smith/smith.htmlhttps://ceb.nlm.nih.gov/proj/ttp/flash/smith/smith.html

suffers with stiffness in his neck. An ailment not tobe treated.”... Gloss: As for: “Thou seest its frag-ments in the interior of his ear,” it means that someof the fragments of the bone come away to adhereto the swab which was introduced to cleanse theinterior of his ear.

15 For a detailed description of the papyrus scrolllook at James Henry Breasted, The Edwin SmithSurgical Papurus, The University of ChicagoOriental Institute Publications.file:///C:/Users/USER/Dropbox/πάπυρος%20Edwit%20Smith%20-%20Αντίγραφο/oip4.pdf

16 More on the contents of The Edwin SmithSurgical Papyrus athttps://faculty.washington.edu/chudler/papy.html . The 48 cases contained within the Edwin SmithSurgical Papyrus concern: 27 head injuries (cases#1-27), 6 throat and neck injuries (cases #28-33), 2injuries to the clavicle (collarbone) (cases #34-35),3 injuries to the arm (cases #36-38), 8 injuries tothe sternum (breastbone) and ribs (cases #39-46),1 injury to the shoulder(case #47), 1 injury to thespine (case #48)

17 In the original text, Case 22 appears as inphoto 1.

18 Neuroscience for Kids; The Edwin SmithSurgical Papyrus The first use of “neuro” words inrecorded history, Case 22. At https://faculty.wash-ington.edu/chudler/papy.htmlThe original text: Case 22: Fracture of the tempo-ral bone (of the skull). This patient could not speakand this case is thought to be the first to documentaphasia. If this is a description of aphasia, it wouldpre-date the famous work on aphasia by Paul Broca(1861) by thousands of years!Case 22 was “An ailment not to be treated.”

19 In the case of aphasia, the person is unable tospeak, to use words correctly and in accordancewith their meaning, to comprehend etc. this couldbe due to disorders in the brain’s blood vessels orbrain damages. General Aphasia is the most seri-ous type of aphasia, during which the patient hasserious problems during speech, as well as under-standing speech. Broca’s Aphasia or expressive

aphasia is characterized by limited speaking ability,limited vocabulary and moderate difficulty in audito-ry comprehension of the language, which oftenleads to difficulty in communication etc.

20 At http://www.crystalinks.com/egyptmedici-ne.html

21 3. HOMERUSEpic.Odyssea, Book 17 line 273

22 Illiad F 410, the goddess Athena speaks: (fool,why haven’t you yet understood how proud I amthat I am braver than you, why do you keep tryingto compare yourself to me, as far as valor is con-cerned? The same in: HOMERUS Epic. Ilias, Book21 line 585 & HOMERUS Epic.Ilias {0012.001}Book 21 line 474 & HOMERUS Epic.Ilias, Book 13line 292 & HOMERUS Epic.Ilias, Book 20 line 244& HOMERUS Epic.Ilias, Book 20 line 200 & HOME-RUS Epic.Ilias, Book 20 line 431

23 (Iliad F 441): : You fool, what a foolish heart youhave (νηπύτι, ως άνοον καρδίαν έχες)

24 1. HOMERUS Epic. Odyssea, Book 2 line 270.The same in the verses that follow: HOMERUSEpic. Odyssea, Book 2 line 278

25 1. ANAXAGORAS Phil. Testimonia Fragment 57line 3, ARISTOT. Metaphys. A 3. 984b 15,Β.ANAXAGORAS Phil. Testimonia, Fragment 15line 6

26 Democritus Β 282 (436, 11)

27 GALENUS Med. In Hippocratis prognosticumcommentaria iii. Kühn volume 18b page 237 line 8:” Πλάτων δ’ ἐν τῷ τρίτῳ τῆϲ Πολιτείαϲ φηϲίν·“εὐλογία ἄρα καὶ εὐαρμοϲτία καὶ εὐϲχημοϲύνη καὶεὐρυθμία καὶ εὐήθεια ἀκολουθεῖ, οὐχὶ ἄνοιαν οὖϲαν,ἣν ὑποκοριζόμενοι καλοῦμεν εὐήθειαν, ἀλλὰ τὴν ὡϲἀληθῶϲ εὖ τε καὶ καλῶϲ τὸ ἦθοϲ κατεϲκευαϲμένηνδιάνοιαν.”

28 EPIPHANIUSScr. Eccl. Panarion (=Adversushaereses) Volume 2 page 390 line 16:Κέχρηνται δὲ ταῖς πάσαις γραφαῖς παλαιᾶς τε καὶκαινῆς διαθήκης, έξεσι δε τισιν αἷς αὐτοὶ ἐκλέγονταικατὰ τὴν ἰδίαν αὐτῶν (15) παραπεποιημένην φρενο-βλάβειάν τε καὶ ἄνοιαν.

ENCEPHALOS 56, 16-29, 2019 25

mailto:pmandr@ymail.com#doc=tlg&aid=0057&wid=099&q=In%20Hippocratis%20prognosticum%20commentaria%20iii&dt=list&st=work_title&per=50mailto:pmandr@ymail.com#doc=tlg&aid=0057&wid=099&q=In%20Hippocratis%20prognosticum%20commentaria%20iii&dt=list&st=work_title&per=50http://www.crystalinks.com/egyptmedicine.htmlhttp://www.crystalinks.com/egyptmedicine.htmlhttps://faculty.washington.edu/chudler/papy.htmlhttps://faculty.washington.edu/chudler/papy.htmlhttps://faculty.washington.edu/chudler/papy.htmlhttps://faculty.washington.edu/chudler/papy.htmlfile:///C:/USER/Dropbox/�������%20Edwit%20Smith%20-%20���������/oip4.pdffile:///C:/USER/Dropbox/�������%20Edwit%20Smith%20-%20���������/oip4.pdf

29 Galen was the last important doctor of the Greco-Roman world at that time. His Roman name is notapparent, but the two initials Cl, that can be seen,most likely come from the Latin word Clarissimus =magnificent, and not from the name Claudius(wikipaideia)https://el.wikipedia.org/wiki/%CE%93%CE%B1%CE%BB%CE%B7%CE%BD%CF%8C%CF%82. A sample depicting the end ofone of Galen’s works, found in KriaraCollection It bears Galen’s peculiar signature as we can

see in the photo 2.

30 His in-depth studies are about anatomy, physiol-ogy, surgery, ophthalmology, obstetrics, pathology,therapeutics, hygiene and pharmacology.https://www.enallaxnews.gr/2017/05/17/to-palimpsisto-tou-galhnoupws-oi-arxaioi-ellhnes-therapevan-tis-astheneies/

31 He described, also, for the first time the periph-eral nerve injuries and their pharmacological treat-ment through the local application of ‘glue’, such asegg white, in order to promote the sealing of nervetruncations (Ochs, 1977).

32 He performed incisions in live animals with greatconsistency, preferably in monkeys and pigs, due totheir similarities to the human body, but denied toperform incisions in human bodies, even if thehuman was dead (Krug, 2008).

33 The number of citations for each of the diseasesof the mind used by Galen came about through ourresearch in the totality of Galen’s surviving body ofwork, as well as those texts that some consider tobe Pseudo-Galen. The relevant research was con-ducted using the Thesaurus Linguae Graecae as itssource.

34 GALENUS Med. Quod animi mores corporistemperamenta sequantur , Kühn volume 4 page787

35 GALENUS Med. De methodo medendi librixiv, Volume 10 page 929 line 17

36 Pseudo-GALENUS Med. Definitiones medicae ,Volume 19 page 415: σμδʹ.

37 GALENUS Med. De symptomatum causislibri iii, Volume 7 page 151 line

38 DEMOCRITUS Phil. Fragmenta, Fragment 32line 3. STOB. III 6, 28. ξυνουσίη ἀποπληξίη σμι-κρή· ἐξέσσυται γὰρ ἄνθρωπος.

39 The term carus, in general, means very deepsleep, stupor, especially after drunkenness, vertigo,lethargy or any type of sudden anesthesia andimmobility of the body.

40 PAULUS Med. Epitomae medicae libri septem,Book 3 chapter 6 section 3.9(2)

41 Balogiannis. Galen as a neuroscientist and aneuron-philosopher in THE BRAIN 2016 (53): 1-14.

42 PAULUS Med. Epitomae medicae libri septem,Book 3 chapter 6 section 3.11.

43 GALENUS Med. De symptomatum differentiisliber, Volume 7 page 60

44 Pseudo-GALENUS Med. Introductio seumedicus, Volume 14 page 741

45 GALENUS Med. In Hippocratis librum iii epi-demiarum commentarii iii, Kühn volume 17a page542

46 Pseudo-GALENUS Med. Definitiones medicae ,Volume 19 page 412

47 GALENUS Med. De methodo medendi librixiv, Volume 10 page 930

48 GALENUS Med. Quod animi mores corporistemperamenta sequantur, Kühn volume 4 page 777

49 Pseudo-GALENUS Med. Definitiones medicae ,Volume 19page 416

50 GALENUS Med. In Hippocratis prorrheticumi commentaria iii, Kühnvolume 16 page 631 line 10

51 Pseudo-GALENUS Med. Definitiones med-icae, Volume 19 page 462 line 11

52 GALENUS Med. De locis affectis libri

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http://historymed.blogspot.gr/#doc=tlg&aid=0057&wid=057&q=De%20locis%20affectis%20libri%20vi&dt=list&st=work_title&per=50https://digital.lib.auth.gr/record/80165/files/01.pdf#doc=tlg&aid=0530&wid=041&q=Definitiones%20medicae&dt=list&st=work_title&per=50https://digital.lib.auth.gr/record/80165/files/01.pdf#doc=tlg&aid=0530&wid=041&q=Definitiones%20medicae&dt=list&st=work_title&per=50http://www.mednet.gr/archives/current-gr.html#doc=tlg&aid=0057&wid=088&q=In%20Hippocratis%20prorrheticum%20i%20commentaria%20iii&dt=list&st=work_title&per=50http://www.mednet.gr/archives/current-gr.html#doc=tlg&aid=0057&wid=088&q=In%20Hippocratis%20prorrheticum%20i%20commentaria%20iii&dt=list&st=work_title&per=50http://stephanus.tlg.uci.edu./Iris/indiv/csearch_red.jsp#doc=tlg&aid=0057&wid=044&q=De%20symptomatum%20causis%20libri%20iii&dt=list&st=work_title&per=50http://stephanus.tlg.uci.edu./Iris/indiv/csearch_red.jsp#doc=tlg&aid=0057&wid=044&q=De%20symptomatum%20causis%20libri%20iii&dt=list&st=work_title&per=50mailto:pmandr@ymail.com#doc=tlg&aid=0057&wid=066&q=De%20methodo%20medendi%20libri%20xiv&dt=list&st=work_title&per=50mailto:pmandr@ymail.com#doc=tlg&aid=0057&wid=066&q=De%20methodo%20medendi%20libri%20xiv&dt=list&st=work_title&per=50mailto:pmandr@ymail.commailto:pmandr@ymail.commailto:pmandr@ymail.comhttps://el.wikipedia.org/wiki/%CE%93%CE%B1%CE%BB%CE%B7%CE%BD%CF%8C%CF%82https://el.wikipedia.org/wiki/%CE%93%CE%B1%CE%BB%CE%B7%CE%BD%CF%8C%CF%82https://el.wikipedia.org/wiki/%CE%93%CE%B1%CE%BB%CE%B7%CE%BD%CF%8C%CF%82

vi, Volume 8 page 177 line 13

53 GALENUS Med. Quod animi mores corporistemperamenta sequantur , Kühnvolume 4 page 787 line 13

54 Pseudo-GALENUS Med. Definitiones medicae,Volume 19page 415

55 GALENUS Med. In Hippocratis prorrheticum icommentaria iii{0057.088} Kühn volume 16 page827

56 Pseudo-GALENUS Med. Definitiones medicae,Volume 19page 415

57 Pseudo-GALENUS Med. Definitiones med-icae, Volume 19 page 413 line 5

58 GALENUS Med. De methodo medendi librixiv, Volume 10page 930.

59 1. ALEXANDER Med. Therapeutica , Volume 1page 527 line 22. And 2. PAULUS Med. Epitomaemedicae libri septem, Book 3 chapter 6 section3.

60 GALENUS Med. De symptomatum differentiisliber, Volume 7 page 60

61 Theophilus was a doctor and a comedy writerfrom Epidaurus. See Verettas Marios. The Namesof the Greeks. In Papyrus Larousse Britannica wehave found the name Theophilus referring to a com-edy writer, contemporary of Phillip and Alexanderthe Great, who, amongst other things, wrote a com-edy under the name Doctor.

62 GALENUS Med. Quod animi mores corporistemperamenta sequantur, Kühn volume 4 page777

64 Pseudo-GALENUS Med. Definitiones medicae ,Volume 19 page 416 line 7

65 ALEXANDER Med. Therapeutica, Volume 1page 595 line 23: Εἰ δὲ ὕλη αἱματικοῦ χυμοῦ σφη-νωθείη περὶ τὸν ἐγκέφαλον, τότε θαρρῶν τὴν ἐν τῷμετώπω φλέβα τέμνε•

66 PAULUS Med. Epitomae medicae libri septem,Book 3 chapter 6 section 3.11.

67 7. GALENUS Med. De symptomatum causis libriiii, Volume 7 page 152 line 8

68 ALEXANDER Med. Therapeutica , Volume 1page 575 line 17

69 GALENUS Med. In Hippocratis librum iii epi-demiarum commentarii iii, Kühn volume 17a page692

70 GALENUS Med. De symptomatum differentiisliber , Volume 7 page 60

71 GALENUS Med. Quod animi mores corporistemperamenta sequantur , Kühn volume 4 page777

72 Alexander Med. Therapeutica, Volume 1 page509

73 Pseudo-GALENUSMed. Definitiones medicae ,Volume 19 page 427 line 9

74 PAULUS Med. Epitomae medicae libri septem,Book 3 chapter 6 section 3.12.

75 GALENUS Med. De locis affectis libri vi, Volume8 page 201

76 Pseudo-GALENUS Med. Definitiones medicae,Volume 19page 415 line 7

77It appears that Galen is the first to suggest theadministration of opium to hyper-active children(Goodman & Gilman, 1975)

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file:///C:/USER/Dropbox/�������%20Edwit%20Smith%20-%20���������/oip4.pdf#doc=tlg&aid=0530&wid=041&q=Definitiones%20medicae&dt=list&st=work_title&per=50file:///C:/USER/Dropbox/�������%20Edwit%20Smith%20-%20���������/oip4.pdf#doc=tlg&aid=0530&wid=041&q=Definitiones%20medicae&dt=list&st=work_title&per=50http://www.pbs.org/wnet/brain/history/#doc=tlg&aid=0057&wid=027&q=Quod%20animi%20mores%20corporis%20temperamenta%20sequantur&dt=list&st=work_title&per=50http://www.pbs.org/wnet/brain/history/#doc=tlg&aid=0057&wid=027&q=Quod%20animi%20mores%20corporis%20temperamenta%20sequantur&dt=list&st=work_title&per=50http://historymed.blogspot.gr/#doc=tlg&aid=0057&wid=057&q=De%20locis%20affectis%20libri%20vi&dt=list&st=work_title&per=50

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